Clearing of red blood cells in lumbar puncture does not rule out ruptured aneurysm in patients with suspected subarachnoid hemorrhage but negative head CT findings.

Background And Purpose: In evaluating the results of lumbar puncture (LP), a decrease in the number of red blood cells (RBCs)/mm3 between the first and fourth tubes collected (clearing) has often been assumed to indicate a traumatic puncture rather than the presence of subarachnoid hemorrhage (SAH). We tested the hypothesis that, in the setting of severe headache, CSF clearing coupled with an unremarkable unenhanced CT scan was negatively predictive of the presence of aneurysm and could be used to reduce the need for conventional arteriography.

Methods: Cerebral angiography was performed to evaluate suspected SAH in 123 consecutive patients over 2 years at a university teaching hospital.

Benign cephalic histiocytosis with diabetes insipidus.

Benign cephalic histiocytosis is a rare skin condition consisting of small tan papules on the face and upper trunk that is believed not to be associated with internal organ involvement. The infiltrating histiocytes are not Langerhans' cells (LCs). We report a 5-year-old girl who presented with diabetes insipidus 1 year after developing multiple small brown asymptomatic skin papules.

Expression of proopiomelanocortin (POMC)-derived melanocyte-stimulating hormone (MSH) and adrenocorticotropic hormone (ACTH) peptides in skin of basal cell carcinoma patients.

We proposed that local expression and production of proopiomelanocortin (POMC) peptides may play a role in human skin physiology and pathology, including the development and progression of skin cancers. Reverse transcription polymerase chain reaction (RT-PCR) and Northern blotting hybridization techniques were used to study gene expression. Reversed-phase (RP) high-pressure liquid chromatography (HPLC) separation with subsequent radioimmunoassays were used to identify alpha-melanocyte-stimulating hormone (alpha-MSH) and adrenocorticotropic hormone (ACTH) peptides.